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Addiction Guide

Addiction is a disease that affects millions of American’s every year by altering the chemistry of our brain. Addiction causes havoc in the reward center of the brain, causing drug users to experience altered emotions, personality, and goals. Those who use drugs don’t intend on becoming addicted, and in several cases pertaining to opioids, it all resulted from an accident and medication to treat their pain. Unfortunately, many fall into a pattern of drug use for many reasons, such as self-medication because of mental illness, peer pressure, or experimentation due to curiosity. There are many reasons why someone will become addicted to drugs, including upbringing, family life, genetics, and environment.

There are many types of illicit substances and prescription drugs that are highly addictive even when used as prescribed by your primary care physician. Even with moderate but regular use, individuals of any age are prone to becoming physically dependent. Once you are in the grips of an addiction, your thoughts, efforts, and actions will be centered around feeding your alcohol or drug addiction. Behaviors you once found unacceptable become the only way to acquire drugs. For this reason, many people fall victim to the ideas and criminal activities of the crowds they associate themselves with and can resort to lying, stealing, or worse.

Depending on the type of drugs that are being used, their amount, and the length of time, trying to get through the withdrawal period on your own is not only a daunting task, but it can be deadly depending on the drug you’re trying to stop. Medically monitored detox is a must to ensure a safe detox process, especially with the recent use of substances such as fentanyl, heroin, benzos, alcohol, or barbiturates. Detox is merely the starting point in a long process, and long-term treatment programs are necessary to establish the foundation for relapse prevention and long-term recovery.

What Is Drug Addiction?

Throughout centuries of drug addiction, it has always been viewed as a moral failing by peers and counterparts, but the more information and research put into studying the problem has discovered that addiction is a chronic and complex disease. As such, addiction primarily affects the part of the brain known as the limbic system, otherwise known as the reward center. Our limbic system links several parts of the brain that have to do with pleasure and learning. Under ordinary circumstances, the limbic system is a crucial part of the brain that encourages participation in the things that help you survive.

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The most common occurrences we experience in life, such as enjoying a balanced dinner, trigger “feel-good” chemicals such as dopamine in our mind. These chemicals are then released into your brain while your limbic system takes note. You begin to subconsciously learn that your body prefers the feeling of being full and satisfied, and the next night, your brain encourages you to repeat these actions through cravings, impulses, and other signs. The reward center response occurs often and can range from anything such as sex or lying in a warm bed. Your brain learns to repeat the moments that make you feel good.

Drugs or alcohol, on the other hand, cause a release of these feel-good chemicals in amounts much more significant and intense than you would experience with something more natural such as food. When the limbic system is met with a fierce reward, it will take immediate notice. After continuing to fulfill these cravings, your brain will begin to associate drug or alcohol use with life-sustaining activities such as eating or sleeping. Even once you abstain from using the substance, you will continue to have cravings for years. A large part of drug addiction treatment is learning how to cope with cravings and triggers without falling victim to picking up the substance again.

What Causes Drug Addiction?

The more we’ve grown to learn about drug addiction, the better we understand that it is not a matter of pharmacology or how chemicals work in the brain. If this were the case, more people would be addicted to chemical substances worldwide. While the numbers are staggering, they still don’t translate to what we would see if that was the case. In 2016 alone, 214,881,622 opioid prescriptions were written, but only a small portion of these individuals became addicted. Every year around the United States, college students binge drink, but they don’t all finish university with an alcohol use disorder. What makes some individuals more prone to addiction than others?

Despite the breakthrough in addiction science, admittedly, there is much more to learn about what causes drug addiction. Fortunately, what we have learned is that there is no single cause. Several factors can influence addiction, and it is typically a combination of factors that eventually lead you down the path of a substance use disorder. Potential causes include biology, environment, and development.

  • Biological factors: Genetic predisposition plays a significant role in the development of an addiction. Studies show a link between someone who is addicted and a family history of addiction, which suggests that a person’s potential for addiction has major biological factors. When studying families, twins, and adopted children, researchers estimate that alcohol dependence has a rate of heritability of 50 percent or more.
  • Co-occurring disorders: Addiction comes with high rates of dual diagnosis, which means other mental disorders such as depression, trauma, anxiety, and mood disorders are often contributors. Undiagnosed mental health problems are a significant risk factor for the development of mental health issues. Often, individuals will turn to drugs or alcohol to cope with their feelings of stress, which is known as self-medication. Substance abuse and addiction make mental health problems much more severe.
  • Environmental factors: The environment we live in has a tremendous impact on the way we perceive and process drug use. Environmental influences can be in your home and include parents or siblings. Those who grew up with attentive parents that educate and warn children about drug use are less likely to fall victim to addiction than someone with inattentive parents that ignore or openly participate in drug use. Neighborhood culture also plays a role. Kids who walk to school through open-air drug markets are over-saturated with alcohol ads and are more prone to developing a drug addiction. Peer pressure, stress, and drug availability are other factors that can originate from where you grow up.
  • Developmental factors: This refers to learned behaviors and developed strengths or weaknesses that you may incur over time. Developmental factors are where your genetics and environment meet. Our brain and body develop until the age of 25, and during that time you are like a sponge that is absorbing everything around you. Addiction can occur at any point in a person’s life, but the first encounter with drugs in your teen years can more than likely lead you to develop a substance use disorder. Certain chemical substances can disrupt your brain development and lead to cognitive issues and problems with decision making and impulsivity. For example, alcohol disrupts a process known as myelination that happens during your adolescent years. Myelination is a period of increased brain development that helps your neurons send messages more efficiently. After prolonged or heavy alcohol abuse in your teens or early 20s, it can permanently stunt cognitive functions. It is not debilitating, but it does lead to slower thinking or poor decision making.

None of these factors listed above indicate that drug addiction is inevitable, and positive results in these categories don’t mean that you’ll be immune to addiction. Still, these factors increase the odds exponentially for addiction and together provide some insight as to why people struggle with addiction while others do not.

How The Brain Communicates

While becoming dependent on chemical substances is a significant piece of drug addiction, it does not equate to addiction. The disease of addiction has to do with the reward center, but drug dependence has to do with brain chemistry and the brain’s communication system. Simply put, the brain communicates by passing chemical messages between nerve cells. Nerve cells are known as neurons, chemical messages are called neurotransmitters, and space through which they pass messages is called the synapse. Specific drugs disrupt this process in different ways, but most affect the messages in the synapse.

  • Stimulants: Cocaine and methamphetamine affect the way dopamine is cycled through the synapse. Cocaine blocks the reuptake of dopamine by changing the part of the sending neuron called the transporters. The transporters are designed to reabsorb neurotransmitters that are no longer needed. By blocking dopamine reuptake, it continues to bind to receptors and creates the energizing effect of excess dopamine. Meth does this as well, but in addition, it increases the amount of dopamine that’s released. So much, in fact, that it can damage dopamine receptors. Those in recovery from meth addiction may experience a diminished ability to experience pleasure from anything other than meth because it is difficult for natural dopamine levels to bind to damaged receptors.
  • Opioids: Opioids are unique in that they have their own naturally occurring receptors in the brain. Our brain produces its version of opioids referred to as endorphins. Endorphins are also used to mitigate pain, and opioids are often used for the same purpose. Opioids, however, are much more potent than your naturally occuring alternatives. Opioids bind to opioid receptors in the body and the brain to stop the body from feeling pain. It also causes euphoria and relaxation.
  • Depressants: Depressants can range from alcohol to benzos, and these increase the efficiency of the chemical gamma-aminobutyric acid (GABA), which decreases the excitability of neurons. It serves to slow the nervous system and reduce anxiety, promote sleep, and stop seizures. When your brain becomes dependent on a central nervous system (CNS) depressant, abrupt cessation can be dangerous. As tolerance grows to these kinds of drugs, your brain produces chemicals to counteract the suppression of the neurons. When our nervous system is unbridled with depressants, it goes into overdrive. An over-excited nervous system can translate to seizures, catatonia, hallucinations, and even death in some cases.

The Addiction Epidemic

The United States is currently struggling amid the worst drug crisis we’ve ever seen. More than 130 people die every day as a result of opioid overdose. Opioids are commonly prescribed to treat pain symptoms due to chronic pain, surgery, and injuries. Because our bodies have built-in opioid receptors at every point on the path pain takes from the pain site to the brain, it’s useful in stopping symptoms in their tracks. Unfortunately, the euphoria that comes with opioid use can be extremely addictive. In many cases, those who use the prescribed opioids as recommended by their doctor will move onto illegally acquired drugs. Opioids are even more addictive, however, when they’re abused.

Opioids have become a mainstream issue for several reasons. The number of prescription opioids began to flood the market between 1999 and 2014. The increase in prescribing opiates saturated the market, which by 2016 created 40 percent of all overdose deaths related to prescription opioids. The majority of these incidents involve abuse of prescription drugs, when individuals take more than the prescribed dose or when people acquire medications from family or friends without a prescription.

Illicit opiates have also come into the United States through illegal channels including Mexican drug cartels. The larger cartels, such as the Sinaloa cartel, have distribution strongholds all over the United States, in almost every major U.S. city. Potent synthetic opioids have also dramatically increased in availability throughout the country causing a deadly surge in synthetic overdose deaths.

Epidemic Statistics Summarized

  • More than 130 people die every day as a result of opioid overdose.
  • The increase in prescribing opiates saturated the market, which by 2016 created 40 percent of all overdose deaths related to prescription opioids.
  • Fentanyl is one of the most powerful drugs in existence, so much so that it is 100 times more potent than morphine at 50 times more potent than heroin.
  • The U.S. Drug Enforcement Administration (DEA) explains that as little as two milligrams of fentanyl can kill the average person.
  • According to the National Survey on Drug Use and Health, they found that 6.2 percent of adults (over the age of 18) met the qualifications for an alcohol use disorder.
  • Only 6.7 percent of people with alcohol use disorders sought addiction treatment.
  • Alcohol is linked to 88,000 deaths annually, which includes overdose, preventable alcohol-related disease, and auto accidents.
  • By 2015, nearly 7,000 deaths were attributed to a cocaine overdose.
  • A study of meth in the state of Wisconsin estimated that its use had jumped by at least 250 percent since 2011.
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Fentanyl Overdose

Fentanyl is one of the most powerful drugs in existence, so much so that it is 100 times more potent than morphine at 50 times more potent than heroin. Fentanyl is used in medical settings in controlled doses. It’s a fast-acting opioid, taking effect in less than five minutes. The quick onset of the drug makes it ideal for epidurals to alleviate labor pains. However, because it is so fast acting, it makes it a concern for drug abuse. Additionally, it is cheap and easy to make in clandestine labs, and the potency makes it easy to transport in small packages.

By cutting fentanyl with heroin, dealers aim to increase their profits. The problem with this is that fentanyl is deadly in the smallest amounts, and it is impossible to guess exact measurements. The U.S. Drug Enforcement Administration (DEA) explains that as little as two milligrams of fentanyl can kill the average person.

In most cases, most opioid users will not seek out fentanyl, but instead, they buy heroin or prescription pills that are laced with the dangerous drug. It can make it into heroin bags or pressed pills, and the user won’t know until it’s too late. They may be expecting a dose they’ve become tolerant to and consume fentanyl, which will cause them to overdose.

Opioids cause your body to slow down, and it relaxes muscles, stops the pain response, and induces euphoria. During an overdose, it can slow breathing down to a point where it stops altogether. Much is still unknown as to why this occurs, but scientists theorize that opioids suppress the body’s ability to detect carbon dioxide levels, which fails to trigger breathing. Opioid overdoses can lead to unconsciousness, hypoxia, brain damage, coma, and death.

Other Drugs in the Epidemic

Opioids are the leader when it comes to the sheer volume of addiction and overdose in the United States, but other drugs pose threats to our public health. Despite its legality, alcohol has been a threat for decades to Americans. Its popularity in our culture means that abuse is prevalent, and according to the National Survey on Drug Use and Health, they found that 6.2 percent of adults (over the age of 18) met the qualifications for an alcohol use disorder. Only 6.7 percent of people with alcohol use disorders sought addiction treatment. Alcohol is linked to 88,000 deaths annually, which includes overdose, preventable alcohol-related disease, and auto accidents.

The use of meth has also risen in the country; while deaths happen at a slower rate from meth than opioids, it does not receive the media attention it deserves. Meth addiction is notoriously difficult to recover from, as meth use damages dopamine receptors making it difficult for you to experience pleasure apart from a meth high. Extreme depression and thoughts of suicide often accompany meth withdrawal. It’s crucial to ask for help if you’re experiencing feelings of self-harm.

Cocaine use and overdose have dropped since its first peak in the 80s and 90s, and its second spike in the mid-2000s. Unfortunately, there has been a steady increase since 2012. By 2015, nearly 7,000 deaths were attributed to a cocaine overdose.

Drug Addiction Treatment

There are several methods to treat drug and alcohol addiction, but there is a debate for the best treatment options. Research evidence does show that effective addiction treatment has several common factors, some of which include:

  • Treatment must be individualized
  • Evidence-based behavioral therapies are recommended
  • Treatment needs to last for an adequate amount of time

Relapse Prevention

Addiction is a disorder that will stick with someone for life, and relapse is the number one threat to people in recovery as cravings can occur long after the chemicals have left your system. Relapse prevention is essential for lasting recovery. There are many ways to prevent relapse that includes residential or intensive outpatient programs that help you identify risky situations and avoid triggers. Active participation and attending support groups like Narcotics Anonymous, Alcoholics Anonymous, and other 12-step programs will help you build your support network.

Family Support

Addiction is known as the family disease, and it’s complicated to watch someone go through the struggles brought on by addiction, mainly because the situation may get out of control. Learning the difference between enabling and helping someone is challenging and stressful. Family support groups can be beneficial to the client and the family.

Finding the Right Drug Addiction Treatment Center

There are many choices when it comes to finding an addiction treatment center, but there are many that don’t offer what the user needs. It’s crucial to identify a treatment center that has proven experience and can safely provide the treatment appropriate for your specific needs. Not all treatment centers will offer the programs necessary for specific addiction disorders.

Sober Living

Sober living is a viable option for those re-entering into the real world after active addiction. As temptations and cravings begin to take hold, the best defense is to place yourself in a positive environment that promotes sobriety. Drugs and alcohol will be unavailable, and allow you to focus solely on your recovery. Residents can learn how to deal with addiction outside the walls of treatment and maintain their sobriety.

Sources

2017 National Drug Threat Assessment. (2017, October). from https://www.dea.gov/docs/DIR-040-17_2017-NDTA.pdf

Alcohol Facts and Statistics. (2017, June). from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

Dick, D. M., Ph.D., & Agrawal, A., Ph.D. (2008). The Genetics of Alcohol and Other Drug Dependence. from https://pubs.niaaa.nih.gov/publications/arh312/111-118.pdf

FENTANYL FAQs. (n.d.). from https://www.dea.gov/druginfo/fentanyl-faq.shtml

National Institute on Drug Abuse. (2014, July). Drugs and the Brain. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

National Institute on Drug Abuse. (2017, September 15). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

National Institute on Drug Abuse. (1999, December 01). Thirteen Principles of Effective Drug Addiction Treatment. from https://archives.drugabuse.gov/news-events/nida-notes/thirteen-principles-effective-drug-addiction-treatment

Opioid Overdose. (2017, July 31). U.S. Centers for Disease Control and Prevention from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

Prescription Opioid Overdose Data. (2017, August 01). U.S. Centers for Disease Control and Prevention from https://www.cdc.gov/drugoverdose/data/overdose.html

Schuppe, J. (2017, July 2). As America deals with its opioid crisis, meth is also on the rise. from https://www.nbcnews.com/news/us-news/twin-plagues-meth-rises-shadow-opioids-n776871

Vargas, W. M., Bengston, L., Gilpin, N. W., Whitcomb, B. W., & Richardson, H. N. (2014, October 29). from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212071/

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